Rev. Stephen Ryan, OSM
Director of Chaplaincy Service
Queen of Angels Hollywood Presbyterian Medical Center
Los Angeles, California
Sue was completing her ICU nursing shift. I was just beginning my evening chaplain shift.
As we walked, she said, “I’ve been wondering about the work you do. What do chaplains really do? I know you respond to codes; I’ve seen you ministering in E.R. I’ve also seen you interacting and praying with patients and families. But I still wonder, what is chaplaincy? There must be a core element underlying the different things chaplains do. We nurses do many things, but nursing is more than just individual medical actions. Is it true that chaplains serve in places other than hospitals?”
“Sue,” I replied, “you ask good questions. Do you have time for a cup of coffee so I could talk about my perception of what chaplains do?” “Of course,” she said.
We sat at a table on the patio and talked for quite a while, with her good questions and my answers going back and forth.
Later, during my shift, it occurred to me that it would be useful to put into writing the kinds of questions and answers we exchanged-about who chaplains are, what we do, and why we are essential in our changing health care environments. I concluded that this is basic information that we ought to find a way to share with our administrators and other health care professionals.
My understanding of who chaplains are, what they do, and where they ought to serve rests upon four assumptions.
- Chaplains are persons who seek to empower persons to be fully human (that is to be whole persons).
- Chaplains minister within the spirituality of the person they serve.
- Every person lives a spirituality.
- But not every person is religious.
I define chaplains as persons called by God and who have been professionally trained and certified to minister to peoples’ spiritual needs within the context of empowering people to be fully human. To be fully human, one must function as well as possible: cognitively, physiologically, psychologically, emotionally, societally, and spiritually in an integrated manner.
The role of chaplains is to assist persons-no matter what the specifics of their life circumstances may be-to be all they can be in body, mind and spirit. That is to be whole persons.
As members of whole person interdisciplinary care teams, chaplains minister in a unique manner to a person’s spiritual needs. It is essential that chaplains be able to distinguish between their own spirituality and that of those they serve. Certainly, the individual chaplain is motivated by his/her personal spirituality. For example, as a Catholic chaplain I minister out of a desire to continue the whole person ministry of Christ. While this motivates me to be who I am, as chaplain my responsibility is to assist those I serve to grow within their spirituality or religious beliefs and practices. It is important to make this distinction between how chaplains live their spirituality while serving persons within their spirituality because that is what enables us to minister to people of diverse spiritualities and religious beliefs.
Wherever chaplains serve, they follow an APIE* care plan similar to the care plan of nurses. The professional chaplain listens carefully as persons relate their life stories. This enables chaplains to assist them, articulate and assess their spirituality. Drawing upon the strengths of this spirituality, together the chaplain and the person create a spiritual care plan to empower the person to cope with whatever is happening in her or his life.
The chaplain coordinates this spirituality care plan with the care plans of the other members of the interdisciplinary team to ensure that unified rather than fragmented care is provided. The chaplains also assist families, friends, faith and spiritual community members to actively participate in the co-journeying.
Chaplains document their ministry in pertinent professional records. Periodically, they evaluate the pastoral care plan’s implementation. When necessary, they make adjustments in their assessment of spiritual needs and the care plan to provide for them.
Chaplaincy, therefore, encompasses a full range of spiritual services, including a listening presence, help in dealing with powerlessness, pain, and alienation. Chaplains assist people to change what can be changed and to cope positively and peacefully with that which cannot be altered.
Succinctly stated, the essential dimension of chaplaincy is spirituality care giving. I define spirituality as the unique capacity of the human spirit to be able to create meaning and purpose in every life event.
At the core of our humanity, we are meaning makers. Consequently, every person lives a spirituality. Every human has a need for meaning; for purpose; for belonging; to be hopeful. Everyone has a sense of union with that which transcends us.
Every spirituality includes these basic human needs: to love; to be loved; to find meaning in what is happening in life events (especially in times of crisis); to have reasons to hope/cope; to be significant to someone and/or for something the person has accomplished.
Spirituality is the lens through which people interpret their universe. It is the basis for how they understand themselves; their multi-dimensional needs; the manner in which they relate to other people and that which they perceive as transcending themselves. This spirituality may or may not be expressed in religious terminology.
Today, many Americans live a secular humanistic spirituality. A commonly accepted definition of this spirituality is “a person’s intangible motivation and commitment directing the self towards ultimate values of love, meaning, hope, beauty, and truth.”
A religious spirituality includes all of these elements as well as a creed; a requisite code of living those beliefs; a cult, meaning a way of worshiping the Transcendent (as defined within that religion’s creed); and a community of believers.
In my opinion, every human has five fundamental spiritual needs.
- Each of us reflects upon the meaning of our life experiences. (For example, in times of illness we ask, “What is happening to me and why?”).
- We are aware that there is someone or a power or value that transcends us. We need to believe that relating to that transcendent other or attaining that value will fulfill our deepest longings for meaning and purpose in our lives. Spirituality writers term this “The Holy.” For many people, but not all, “The Holy” will be their understanding of God.
- Because we naturally strive to avoid pain, we have a need to try to change whatever causes us to suffer or be unhappy.
- We have an innate need to be persons of hope no matter how difficult our life may be.
- People need people. We need to believe there are people who care about us and are willing to co-journey with us.
In assisting people to meet these deep-seated spiritual needs, the chaplain enables people to articulate their spirituality in either religious or non-religious terminology. They empower them to draw upon the strengths of that spirituality to meet the challenges of their lives.
It is this ability and goal which distinguishes chaplains from other members of the interdisciplinary team. It is this ministry that defines our unique contribution to whole person care and makes us indispensable. It is an ability learned through professional education and certified by a recognized certifying organization, such as the National Association of Catholic Chaplains or the Association of Professional Chaplains.
The importance of chaplaincy to whole person care can be exemplified by examining its role in managed health care-the very place where many administrators fail to understand its necessity. Within managed health care, chaplains are not cost, but revenue centers. Wellness programs designed to limit the need for acute health care are the cornerstone of managed health care. Whole person wellness is possible only if humans’ total needs, including spiritual, are met. This is possible only if managed care organizations provide professionally trained spirituality co-journeyers to assess and minister to clients’ spiritual needs even as they do for their physical and emotional needs.
Numerous studies have shown that three-fourths of all illnesses are rooted in emotional, psychological, and spiritual causes. Studies by the Center for Disease Control have shown that as many as two-thirds of the years of life lost before the age of 65 are preventable using currently available knowledge and technology. Many of these lost years of living are the result of unhealthy life style choices; of persons striving to create meaning of life through choices which in reality cause death: violence, addictions, poor nutrition, failure to exercise or deal with stress in a positive manner, etc.
The search for meaning, for joy and purpose in life is a spiritual quest. Chaplains capable of assessing spiritual needs and with the person served developing a spirituality care plan within the context of whole person health are necessary if we are to enable people to live as they were created to live.
Defining the importance and uniqueness of chaplaincy enables us to answer questions about where chaplains minister. A succinct response is-wherever whole person care is taking place: whether inside or outside institutions! Wherever there are persons with spiritual needs, there needs to be chaplaincy ministry available.
Defining chaplaincy’s unique ministry communicates its necessity. Today’s challenge for chaplains is to clearly assert who we are, what we do, and identify in a given ministry why we are essential. Through such assertions, chaplains change the administrative (often bottom-line) question, “Why chaplains?” into “How could we be true to our whole person mission unless we employ chaplains?”
The more people know who chaplains are and what we do, the better we can be the spirituality empowerers we are called to be.
* APIE: assess/analyze, plan/prioritize, implement/intervene, evaluate.
This article first appeared in Vision, January 1997 (Vol. 7, No. 1, pp. 8–9).